Ms. F. arrived at the hospital on April 4, 2021, at 34 weeks pregnant when her blood pressure rose https://nida.nih.gov/about-nida/noras-blog/2023/02/pregnant-people-substance-use-disorders-need-treatment-not-criminalization, [2] Substance Use Disorder Hurts Moms and Babies. Published July 21, 2021. https://www.cdc.gov/pregnancy/opioids/basics.html, [19] Honein MA, Boyle C, Redfield RR. Treatment decisions, especially those involving empiric treatments, should be informed by knowledge of influenza activity in the community. During this time, a DCFS agent and another state employee came regularly to Ms. F.s home to check in on her and the baby. or the [child neglect statute]. Resource lists for health care providers are available inAppendix Bof the report. J Pediatr. How some hospitals are drug testing new mothers without consent, How Alabamas meth lab law is unfairly punishing pregnant women, Mothers: tell us about drug testing at your hospital. Pregnancy Justice and ACLU of Illinois File Human Rights - NAPW Fighting Back Against the Non-Consensual Drug Testing of Pregnant Women The Maternal Lifestyle Study. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Ultimately, DCFS subjected Ms. F. and her husband to a safety plan, requiring them to have someone else in the home with Ms. F. and the baby at all times. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. NCDAS. | Terms and Conditions of Use. How States Handle Drug Use During Pregnancy http://projects.propublica.org/graphics/maternity-drug-policies-by-state, [30] NCDAS: Substance Abuse and Addiction Statistics [2023]. Meconium the traditional specimen to detect and document drug use during pregnancy, while umbilical cord tissue is relatively new for testing. ACLU of Illinois Responds to Decision by Texas Court on With The Patient and Provider Protection Act, Illinois Shows Once HB 4664: Patient and Provider Protection Act. Future interventions should focus on improving the oral health knowledge of dentists and other health professionals about the importance of comprehensive oral health care, including periodontal treatment when needed, for all pregnant women. Screening for substance use in all pregnant women is recommended by both the American College of Obstetrics and Gynecology (ACOG) and the American Society of Addiction Medicine (ASAM) in order to provide women and their fetuses and children with the best care during and after pregnancy. However, some studies of hospitalized patients with influenza, including an analysis of hospitalized pregnant women, have suggested benefit of antiviral treatment even when treatment was started more than 48 hours after illness onset. [36] Moreover, oxytocin, the hormone responsible for mother-baby bonding, is increased in breastfeeding mothers, reducing withdrawal symptoms and stress-induced reactivity and cravings while also increasing protective maternal instincts. Pregnancy Justice and ACLU of Illinois File Human Rights Complaint on Behalf Of New Mother Who Endured Non-Consensual and Discriminatory Drug Testing, Reporting to DCFS Because of Poppy Seed Consumption - New York | Pregnancy Justice NPR. ACOG joins every leading medical and public health organization in approaching the problem of drug and alcohol use during pregnancy as a health concern thats best addressed through education, prevention and community-based treatment, not through punitive drug testing and reporting laws or criminal prosecution. If the patient or baby is unsafe, a caregiver could intervene while the patient re-enrolls in the program. The practice of drug testing pregnant women without their knowledge or consent is common in New York, according to NAPW and NYCLU, but is not supported by leading medical organizations. The Reproductive Health Act (RHA) says that the government cannot punish or prosecute for something a pregnant woman may or may not have done due to the government's claim that it is harmful. How States Handle Drug Use During Pregnancy Drug Testing During Pregnancy | Quest Diagnostics Their newborns can be taken from them. In three states Minnesota, South Dakota and Wisconsin women who use drugs during pregnancy can be involuntarily committed to a treatment program. Voices in Bioethicsbrings together diverse views through an academically rigorous online format and seeks to identify issues and present workable long-term solutions. Nations Health. It is a healthcare providers duty to provide non-judgmental care that prioritizes the patients well-being. States handle drug use during pregnancy differently. There is no medical justification for drug testing all perinatal patients, and the practice is widely opposed by leading medical organizations. I. Misconception One: Mothers with Substance Use Disorder Can Get an Abortion. Incentivizing pregnant women with substance use disorder to safely address their chronic health issues is essential for minimizing negative short-term and long-term outcomes for women and their newborns. NAS is a group of conditions caused when a baby is exposed to certain drugs in the womb, most often opioids, and is withdrawn from those drugs after birth. This practice arose out of the failed War on Drugs, which advanced a narrative that cast suspicion on people of color and resulted in federal laws to ostensibly provide drug treatment to pregnant women. Yet I felt for the new mothers and realized that heart-wrenching custody loss is not the best approach. ET), 2023 Annual Clinical & Scientific Meeting, Congressional Leadership Conference (CLC), Alliance for Innovation on Maternal Health, Postpartum Contraceptive Access Initiative, Expanding Medicaid coverage from 60 days to one year after delivery, including for SUD and mental health screening and treatment and case management and outreach services, Access to medically-assisted treatment (opioid agonist pharmacotherapy), Adequate postpartum psychosocial support services including SUD treatment and relapse prevention programs, An increased focus on curbing alcohol and tobacco use during pregnancy. For more information on antivirals for pregnant and postpartum patients, please visit the CDC: https://www.cdc.gov/flu/professionals/antivirals/avrec_ob.htm. Rather than policing and criminalizing substance use, pregnant women should get the appropriate care they need and deserve. There are ways you and your partner can prevent passing HIV to one another or to your baby. NAS can lead to long-term health and developmental problems such as hearing and vision problems and issues with learning and behavior. Eighteen states have laws that say drug use during pregnancy is child abuse. February 3, 2022 CHICAGO - On January 28, 2022, National Advocates for Pregnant Women (NAPW) and the ACLU of Illinois filed a charge of discrimination against Saint Alexius hospital with the Illinois Department of Human Rights for a discriminatory, non-consensual drug test of a first-time mother, Ms. F., before she went into labor. [27], While I have witnessed this behavior in the teenage patient during my pediatrics rotation, not all newborns with intrauterine drug exposure are inevitably bound to have psychiatric and behavioral issues later in life. In the past few years, Illinois and 20 other states have been working towards making significant changes by amending laws to protect the potential life of fetuses. If found guilty, pregnant women could face up to 15 years in prison and lose custody of their child. The subcommittees have started reviewing 2016 maternal deaths in an effort to identify changing trends and areas for statewide improvement with the ultimate goal of preventing maternal mortality. The Illinois Supreme Court's ruling in response to substance abuse (and other harmful effects on the fetus) during pregnancy: Despite the Illinois Supreme Court's ruling that the fetus is not a separate legal person until it is born, cases like The People of the State of Illinois, Petitioner-Appellee,v. ASPE. Addiction is like any other disease and society should regard treatment without stigma. The Wisconsin law is especially draconian: A woman can be detained against her will for the duration of her pregnancy, her fetus has its own court-appointed lawyer, she can lose custody of her baby after birth and the proceedings are mostly secret. Papersaddressing access to healthcare, the bioethical implications of recent Supreme Court rulings, environmental ethics, data privacy, cybersecurity, law and bioethics, economics and bioethics, reproductive ethics, research ethics, and pediatric bioethics are sought. Breastfeed Med Off J Acad Breastfeed Med. https://leg.mt.gov/bills/2019/billhtml/SB0289.htm. They can lose custody of their other children. They must treat these mothers with the same empathy and respect as any other patient, even if they are experiencing withdrawal. Maternal Morbidity and Mortality - Illinois This article highlights some misconceptions and underscores the challenges they face as they navigate the justice and healthcare systems while also providing possible solutions to address their underlying addiction. By what objective standard could a jury be guided in determining whether a pregnant woman did all that was necessary in order not to breach a legal duty to not interfere with her fetus' separate and independent right to be born whole?". The newborns I observed during my pediatrics rotation probably could have benefited from breastfeeding rather than bottle feeding and being passed around from one nurse to the next. Photo by 14825144 Alita Xander | Dreamstime.com. Routine urine drug screening is controversial. National Advocates for Pregnant Women (NAPW) and the ACLU of Illinois filed a charge against St. Alexius Medical Center for a discriminatory, non-consensual drug test against a first-time mother, Ms. F., before she went into labor. Centers for Disease Control and Prevention. Hospitals should provide training and resources to staff on racism, implicit bias, and stigma. Emphasizing public health measures and adequate medical care can prevent complications and developmental issues in newborns and pregnant women with substance use disorders. DHHS Revised September 11, 2018 https://aspe.hhs.gov/reports/economic-opportunity-opioid-crisis-geographic-economic-trends, [14] Midon, M. Z., Gerzon, L. R., & de Almeida, C. S. (2021). Tennessee is the only state with a statute that specifically makes it a crime to use drugs while pregnant. The Pennsylvania Supreme Court ruled in 2018 that prenatal exposure to substances does not constitute child abuse under the state's Child Protective Services Laws. This routine practice, sometimes termed "test and report," disrupts bodily autonomy of the pregnant person and their newborn and is inconsistent with treating substance use disorder as a health condition with social and behavioral dimensions (See "Test and Report: Bad for Children and Families" at States that Drug Test Newborns 2023 - worldpopulationreview.com Pediatrics. 1992;267(3):406-408. doi:10.1001/jama.1992.03480030084043, [24] NICHD Neonatal Research Network. Ms. F. arrived at the hospital on April 4, 2021, at 34 weeks pregnant when her blood pressure rose due to preeclampsia. You can take important steps for you and your partners health, regardless of your pregnancy wishes. Five Great Benefits of Breastfeeding. Policies Affecting Pregnant Women with Substance Use Disorder Alcohol Clin Exp Res. Additionally a flu shot given during pregnancy has been shown to lower risk of flu illness and flu-related hospitalizations in their infants for the first several months of life. Those currently serving sentences in prisons and jails can treat their substance use disorder through medication assisted treatment, cognitive behavioral therapy, and programs like Self Taught Empowerment and Pride (STEP). On October 18, 2018, IDPH released Illinois firstMaternal Morbidity and Mortality Report. [24] One of its studies revealed one month old newborns with cocaine exposure had lower arousal, poorer quality of movements and self-regulation, higher excitability, more hypertonia, and more nonoptimal reflexes.[25] Another study showed that at one month old, heavy cocaine exposure affected neural transmission from the ear to the brain. Some states consider substance misuse (and even prescribed use) during pregnancy child abuse. [40] Drug Related Crime Statistics [2023]: Offenses Involving Drug Use. Unless otherwise noted, you can republish our stories for free if you follow these rules. And even if the mothers were lethargic and unresponsive while going through withdrawal, it would still have been possible to breastfeed with proper support. Source: ProPublica research by Leticia Miranda and Christine Lee; Guttmacher Institute; National Advocates for Pregnant Women. Laws on. https://drugabusestatistics.org/drug-related-crime-statistics/. Pediatrics. IDPH is funding local organizations to increase the number of women receiving well-woman exams. [21] Currently, the impact of the COVID-19 pandemic on the prevalence of newborns with neonatal abstinence syndrome is unknown. View Drug Testing Services Marijuana Laws for Illinois Marijuana considerations are important and marijuana laws often update often, check out Marijuana in the Workplace. Because they did not have a family member who could help, the family was forced to pay a stranger to be in their home for hours when the husband was away at work. Addressing Opioid Use Disorder to Improve Maternal and Infant Health If an unplanned pregnancy occurs, one course of action could be to terminate the pregnancy. Intensive oral hygiene regimens decrease the incidence of gingivitis among pregnant women. Monitor, Analyze, and Communicate Trends. The report identifies statewide trends in maternal deaths and provides recommendations to help prevent maternal mortality. It must be asked, by what judicially defined standard would a mother have her every act or omission while pregnant subjected to State scrutiny? On April 29, 2021, IDPH released Illinois' second Maternal Morbidity and Mortality Report. ", "a judicially defined standard of conduct would have to be met. Oral health is essential to overall health in the prenatal period. 2010;40(3):E11-E11. It is the first charge of its kind in Illinois. In some cases, police can even take a woman into custody if they suspect her substance abuse will harm her unborn child, even involuntarily commit until the child is born. In Illinois, substance abuse is not a crime. The report is the culmination of more than a year of work done by two IDPH committees, the Maternal Mortality Review Committee (MMRC), established in 2000, and the Maternal Mortality Review Committee for Violent Deaths (MMRC-V), established in 2015. For example, many women with substance use disorder lose custody of their baby or face criminal penalties, including fines and jail time. Two modes of testing are available: umbilical cord tissue and meconium. Officials have prosecuted countless women across 45 states for exposing their unborn children to drugs. Newborns' exposure to drugs: Discrepancies in mandatory reporting However, a fetus cannot metabolize the alcohol to get it out of its system like the mother. Int J Drug Policy. 2003;142(3):279-285. doi:10.1067/mpd.2003.112, [27] Bada HS, Bann CM, Bauer CR, et al. Furthermore, cognitive behavioral therapy can help to identify triggers and teach healthier coping mechanisms to prepare for stressors outside of jail. [41] Association APH. After repeal, the Judge did not want to terminate the respondent's parental rights because of the respondent's "outstanding" rehabilitation efforts. Acta Paediatr. https://nida.nih.gov/publications/research-reports/methamphetamine/what-are-risks-methamphetamine-misuse-during-pregnancy, [18] CDC. View Marijuana Laws J Addict Med. Published April 11, 2022. https://www.cdc.gov/tobacco/basic_information/health_effects/pregnancy/index.htm, [17] Abuse NI on D. What are the risks of methamphetamine misuse during pregnancy? Most women are healthy during pregnancy, meaning they experience a typical outcome with no complications. [32] For someone who may or may not have access to reliable transportation, traveling to another state might be impossible. In Alabama, a positive drug test can have dire repercussions for pregnant women and new mothers. Voices in Bioethics is currently seeking submissions on philosophical and practical topics, both current and timeless. by psmith, December 23, 2021, 01:00am, (Issue #1147) Posted in: . Providers should ensure all women are discharged from the hospital with an early postpartum visit within three weeks of pregnancy. Medication assisted treatment under the supervision of medical professionals can help inmates achieve and maintain sobriety in a healthy and safe way. A woman can be found guilty of child abuse or neglect in Illinois if the child's blood, urine, or meconium tests positive for drugs at birth. Ms. F. v. St. Alexius Medical Center | ACLU of Illinois The court found that because the act of birth had not yet occurred, the fetus is not legally considered a child. Click here to learn more about flu vaccine safety and pregnancy: The Centers for Disease Control and Prevention (CDC, 2017) Flu Vaccine Safety and Pregnancy. The following four states require testing if drug use during pregnancy is suspected (risk-based testing): Iowa, Kentucky, Minnesota, and North Dakota. Finally, multimodal empowerment programs can connect people to jobs, education, and support upon release. SB 25: ILLINOIS REPRODUCTIVE HEALTH ACT JAMA. After withdrawal, those struggling with substance use disorder may still have cravings and the likelihood of relapsing remains high without proper medical intervention. IDPH will continue to support the Maternal Mortality Review Committees and will use new data tools to look at social and community factors influencing maternal health. There can be no significant change if society continues to view those with substance use disorders as underserving of care. For immediate service for employers or individuals call 866-843-4545 or Order Now. Society needs to change from the mindset of tackling a problem after it occurs to taking a proactive approach by addressing upstream factors, thereby preventing those problems from occurring in the first place. The Healthcare worker must report drug abuse and direct you to Drug & Alcohol Detox & Rehabilitation Centers For Pregnant Women. 102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 HB4116 . As for illegal substances like cocaine, marijuana, and methamphetamine (and more) - the mother may not have long-lasting effects on drug use, but the fetus is likely to endure a variety of development problems. A common flu symptom is fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. ACOG states, "Urine drug testing has also been used to detect or confirm suspected substance use, but should be performed only with the patient's consent and in compliance with state laws." However, newborn infants may be tested without the mother's consent. Newborn Drug Screening - Meconium and Umbilical Cord Tissue Neonatal exposure to some drugs during pregnancy can have harmful effects on development and may lead to acute adverse events, including neonatal abstinence syndrome (NAS) and infant mortality. Most babies with NAS get treatment in the hospital after birth and typically get better within a few days or weeks. [41] It is erroneous to assume that their substance use disorder would disappear after a period without substance use while behind bars. [1] These punitive measures may cause patients to lose trust in their physicians, ultimately leading to high-risk pregnancies without prenatal care, untreated substance misuse, and potential lifelong disabilities for their newborns. Distributed through Columbia Universitys Academic Commons. Please try reloading page. Despite this, routine oral health care is often avoided or postponed for the duration of pregnancy. Appointment reminders and an immunization tracker can be used to support a woman in getting the vaccines she needs for herself during pregnancy and for her new baby. [29] With opioid and polysubstance use on the rise, the efficacy of laws that result in punitive measures seems questionable. PMID: 31567599. Efforts to inform health professionals about the connection between oral health and overall health during pregnancy should focus on effectively disseminating strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improving oral-systemic health among women and children. The estimated prevalence of maternal drug use during pregnancy is based on maternal self-report but is likely an underestimate because of known underreporting by pregnant women. 2022;99(2):316-327. doi:10.1007/s11524-022-00610-0, [23] Mayes LC, Granger RH, Bornstein MH, Zuckerman B. In Minnesota and North Dakota, a test is required if drug-related complications occur at birth. Womens Health Issues Off Publ Jacobs Inst Womens Health. Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance. Montana, for example, passed a law in 2019 that provides women with substance use disorders safe harbor from prosecution if they seek treatment for their condition. Alabama and South Carolina have interpreted existing child endangerment and chemical endangerment statues to all prosecution of drug-using pregnant women. Please go to www.prep4illinois.com or call the hotline at (800) 825-3518. Excessive alcohol consumption can result in fetal alcohol syndrome, characterized by growth deficiency, facial structure abnormalities, and a wide range of neurological deficiencies. This work is licensed under a Creative Commons Attribution 4.0 International License. June 2021. In 1914, Congress enacted the Harrison Narcotics Tax Act to target the recreational use of drugs such as morphine and opium. [22], In the 1990s, concerns arose about the potentially irreparable damage caused by intrauterine exposure to cocaine on the development of infants, which led to the popularization of the term crack babies.[23] Although no strong longitudinal studies supported this claim at the time, it was not without merit. The maternal lifestyle study: effects of substance exposure during pregnancy on neurodevelopmental outcome in 1-month-old infants. 2013;102(11):1060-1066. doi:10.1111/apa.12378, [36] Ilett KF, Hackett LP, Gower S, Doherty DA, Hamilton D, Bartu AE. Another proactive approach could be to have medical residency programs register with the Drug Enforcement Administration (DEA) as Narcotic Treatment Programs and incorporate suboxone clinics into their education and rotations. An exception to this is in cases where the mother's life is at risk. No one ever informed her of, nor asked her permission for, a drug test. Pregnancy-Related Death- The death of a woman during pregnancy or within one year of the end of a pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy. There are advantages and disadvantages to both universal and risk-based testing. The two Maternal Mortality Review Committees reviewed 129 maternal deaths that occurred during 2016-2017 to develop the recommendations in the report. The Maternal Lifestyle Study (MLS): effects of prenatal cocaine and/or opiate exposure on auditory brain response at one month. St. Alexius staff drew Ms. F.s blood and gathered her urine, which she assumed was for reasons related to her preeclampsia. 19 states have either created or funded drug treatment programs specifically targeted to those who are pregnant, and 17 states and the District of Columbia provide pregnant people with priority access to state-funded drug treatment programs. 2013;2013:579310. doi:10.1155/2013/579310, [34] CDC. Committee members aimed to gain a better understanding of the causes of maternal mortality, to develop statewide recommendations to prevent future maternal mortalities, and to determine whether the deaths were pregnancy-associated (occurring within one year due to any cause) or pregnancy-related (occurring within one year due to pregnancy). [26] Long-term follow up from the study showed that at seven years old, children with high intrauterine cocaine exposure were more likely to have externalizing behavior problems such as aggressive behavior, temper tantrums, and destructive acts. Avoid close contact with those who are sick, Avoid touching your eyes, nose or mouthafter you have touched objects that could possibly be contaminated, Clean/disinfect frequently touched surfacesat home, school or work, especially when someone is ill, Eat nutritious foods and drink plenty of fluids. To promote continuity of care, health officials could include financial incentives to motivate new mothers to go to follow-up appointments. Exciting advances in HIV treatment and prevention make pregnancy a safe possibility for women living with HIV. IDPH is expanding funding and increasing awareness of the state perinatal depression MOMS hotline. Illinois Drug Use and Pregnancy Laws and Other Rulings